Provider Demographics
NPI:1174859045
Name:MANHATTAN PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:MANHATTAN PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:M
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:212-213-3480
Mailing Address - Street 1:276 5TH AVE
Mailing Address - Street 2:202
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-4509
Mailing Address - Country:US
Mailing Address - Phone:800-754-0488
Mailing Address - Fax:888-511-6713
Practice Address - Street 1:276 5TH AVE
Practice Address - Street 2:202
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-4509
Practice Address - Country:US
Practice Address - Phone:800-754-0488
Practice Address - Fax:888-511-6713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY02347212251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400015950OtherMEDICARE PTAN